Over the past 20 years, the Atherosclerosis Risk In Communities (ARIC) Study has provided important new information on risk factors for atherosclerosis and its progression, on risk factors for coronary heart disease and stroke, and on trends in community rates of cardiovascular disease. We herein propose continuation of ARIC from 2005 to 2012. There are separate proposals for each ARIC Field Center, the Coordinating Center, and the Laboratories. Our aims for renewal in response to the ARIC RFPs are: 1. Completion of 23 years of coronary heart disease (CHD) surveillance in the four ARIC communities, permitting detection of trends in CHD incidence, case fatality, and mortality in race-sex-specific subgroups. For 2005-2009, CHD Surveillance will expand to 75-84 year old, and inpatient (55 years and older) and outpatient (65 years and older) heart failure surveillance will be undertaken. 2. Follow-up of ARIC's previously examined cohort for cardiovascular disease (CVD) morbidity and mortality over 23 years, to identify factors related to incident CHD, stroke, and for 2005-2009, heart failure. 3. Identification and characterization of novel genetic and biochemical risk factors for CVD using stored blood, urine, and DNA samples from available subclinical disease cases, available and newly-occurring CVD cases and control subjects, and subgroups with rapid progression of subclinical disease. The genes and analytes to be measured will be identified via a pathway approach to atherosclerosis and CVD. An extension will enable ARIC to continue to (1) address community trends in CVD and (2) make use of its valuable database and biosample resource to address new questions on the etiology of cardiovascular disease. The Washington County Field Center will continue to contribute high quality data in a timely manner as well as collaborate on all study activities, provide leadership in selected areas and promote the widest use and publication of ARIC study data.